The best physicians are multidimensional
No, this is not a science fiction reference. Rather this represents, at least in my mind, the many skills necessary to become a superb clinician. I write this from the perspective of an internist, but I believe these skills are not specialty specific.
History taker – most patient encounters start with taking a thorough history. We have to learn how to ask questions and varying our words according to the patient’s background. We take a different history from a college graduate than we do from a rural farmer. History taking also requires understanding what each answer means and what follow-up questions those answers indicate. The best physicians also read body language and understand when to probe and when to wait for the patient to continue.
Physical examination – not all situations benefit from the physical exam. Contrary to some experts, I believe the physical exam helps in some patients. I have made diagnoses primarily because a physical finding prompted a specific diagnostic process.
Test interpretation – even though we seemingly rely on testing more in 2017 than 1975 when I was an intern, many physicians lack test interpretation expertise. This deficiency seems strange given the success of the CSI franchise. Too often I see tests ordered, and the results not interpreted or interpreted incorrectly.
Clinical reasoning – the process of understanding all the clues and working towards a diagnosis. We know that diagnosis is j...
Source: DB's Medical Rants - Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
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